Bird J H, Luke D P, Ward N J, Stewart M P M, Templeton P A
Department of Orthopaedics West Middlesex University Hospital, Isleworth.
J R Army Med Corps. 2005 Sep;151(3):179-85. doi: 10.1136/jramc-151-03-09.
Cervical spine fractures and dislocations are uncommon injuries that can have serious neurological consequences. These injuries require adequate stabilisation to prevent further spinal cord injury during transfer between hospitals. Evacuation often requires a combination of road ambulance, helicopter and fixed wing aircraft from military hospitals. This paper outlines the neck injuries sustained during Op Telic and discusses the need for Halo vests to be available at Role 3.
The MND(SE) Hospital databases were used to identify all casualties admitted with either a "Cervical" or "Neck" injury. The databases covered the period from 24 March 2003 until 15 April 2004. The diagnoses were categorised into minor and serious cervical spine injuries. We defined a serious cervical spine injury as either a fracture or dislocation. We looked at the discharge letters of all casualties evacuated to a Role 4 hospital to confirm whether the casualties had serious cervical spine injuries.
Forty seven casualties were admitted and all were British except three, two Iraqi civilians and one US soldier. Thirty three casualties were returned to their unit for duty, or discharged at the airhead on return to the UK. Fourteen casualties required hospital treatment. There were five serious cervical spine injuries over the study period which included one Hangman's fracture of C2, one flexion compression injury of C5, one flexion compression injury of C7, one unifacetal dislocation and one bifacetal dislocation.
Five casualties were treated at MND(SE) Hospital for serious injuries to the cervical spine. Two patients were transferred without Halo stabilisation after failing to obtain halos in Iraq. One casualty was kept until a Halo was flown out from the UK.
All unstable cervical spine fractures should be stabilised with a Halo Vest prior to transfer from Role 3. Halo Rings and Vests should be available at Role 3 facilities.
颈椎骨折和脱位是罕见的损伤，可能会导致严重的神经后果。这些损伤需要充分的固定，以防止在医院之间转运过程中脊髓进一步受损。疏散通常需要综合使用公路救护车、直升机和来自军事医院的固定翼飞机。本文概述了在“特利克行动”期间所遭受的颈部损伤，并讨论了在3级医疗单位配备 Halo 背心的必要性。
使用多国师（东南）医院数据库来识别所有因“颈椎”或“颈部”损伤而入院的伤员。数据库涵盖了2003年3月24日至2004年4月15日期间。诊断结果分为轻度和重度颈椎损伤。我们将严重颈椎损伤定义为骨折或脱位。我们查看了所有被疏散到4级医院的伤员的出院信件，以确认这些伤员是否患有严重颈椎损伤。
共收治了47名伤员，除3人外均为英国籍，其中2名是伊拉克平民，1名是美国士兵。33名伤员返回其部队继续服役，或在返回英国时在空投场出院。14名伤员需要住院治疗。在研究期间有5例严重颈椎损伤，其中包括1例C2椎弓根骨折、1例C5屈曲压缩伤、1例C7屈曲压缩伤、1例单侧关节突脱位和1例双侧关节突脱位。
5名颈椎严重受伤的伤员在多国师（东南）医院接受了治疗。2名患者在伊拉克未能获得 Halo 固定装置后，未进行 Halo 固定就被转运。1名伤员一直留院，直到从英国空运来一个 Halo 固定装置。
所有不稳定的颈椎骨折在从3级医疗单位转运前都应使用 Halo 背心进行固定。3级医疗单位应配备 Halo 环和背心。
